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Patient Assistance Information

 
 
 
Support Path Patient Assistance Program


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Phone : (855)769-7284
Fax: (855)298-8700
Eligibility
> Must be uninsured and be ineligible for federal or state programs; or have a plan design limitation. Medicare Part D patients are not eligible for this program. Income must be a or below 500% of FPL* (see below). Must reside permanently in the US or US territories.
Who Can Apply
> Call to have application faxed, mailed or download from website. Return application via fax or mail. A decision will be received by phone or mail in 2 business days, once application process is complete.
Required
> Diagnosis/Medical Criteria *See Additional Information section below. Doctor must complete and sign application. Patient must complete application, sign, attach proof of income and any insurance information.
Supply
> Up to a 28 day supply. Company contacts patient to arrange refills. 2 enrollments per lifetime. Re-application process determined case by case.
Ship To
> Ship to Doctor's office or patient's home within 2-3 business days.
Note
> *500% FPL or less than $100k for the household This program also provides copay assistance. Patient must be diagnosed with Chronic Hepatitis C.
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Harvoni tablet
Sovaldi tablet
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Support Path Patient Assistance Program
(Requires Acrobat Reader